Crisis in health and social care for older people

A damning report by Age UK finds that the health and care system for older people in England is under severe stress and is underperforming, leading to higher costs, poorer health outcomes and worse patient and service user experience.

The disturbing findings presented in this comprehensive report suggest ‘a destructive vicious circle' according to charity director Caroline Abrahams, as inadequate access to high quality social care is progressively sapping the resilience both of NHS services and of older people who are at risk of poor health.

The numbers of older people in England are steadily growing, and those with long term conditions growing faster still, but overall, investment in healthcare is failing to keep pace and funding for social care has very significantly declined.

Between 2005 and 2016 the number of people aged 65 or over in England increased by 18.8% (or by 1.5million people) with the biggest growth amongst the over 85s (up by 29.3%). Community based services on which many older people depend in order to sustain their independence have seen the sharpest falls and elsewhere supply is often failing to meet rising demand.

In light of this, the report 'The health and care of older people 2015' builds on Age UK's earlier work, presenting an updated analysis of the state of social care as well as examining key trends across the NHS and presenting the latest insights into the health and care needs of an ageing population.

The report looks at the:

• growing need for health and social care services
• the rising numbers of people living with complex needs
• trends in funding, activity and the workforce across the health and social care system
• evidence of growing pressure and stress across the health and social care system
• the degree to which health and social care services are effectively supporting people to stay well and independent

Taken as a whole, the report paints a sobering picture of two systems under great stress.

'The Government has the power to change this'

Caroline Abrahams, Charity Director at Age UK said:

‘All the data in this report points in the same direction. The numbers of older people in England are steadily growing, and the proportion with long term conditions is growing faster still, but investment in health care overall is failing to keep pace and spending on social care has fallen quite spectacularly over the last five years.

‘On the whole it is the community based services which help older people to sustain their independence which have seen the sharpest falls, or where supply is most obviously failing to meet rising demand. So, for example, GPs numbers are not keeping up with a growing older population and meals-on-wheels provision, once a mainstay of community care, is rapidly falling away.

‘Our health and social care system is designed so that social care and the NHS interact and support each other to help keep older people fit and well, but starving social care of resources is seriously undermining the NHS - our hospitals especially. This can be seen in the latest worrying figures for delayed discharges from hospital and emergency readmissions.

‘Hospitals and other services are forced to ‘run hot' due to the extra pressure, increasing stress on the staff and making it ever harder to recruit and retain them. This is a destructive vicious circle and we are really worried that it seems to be getting worse.

Older population 'steadily rising'

‘There is a lot of ingenuity and commitment within our health and care system but even so, it is hard to see it being a match for the consequences of a steadily rising older population, combined with health spending failing to keep pace and social care spending significantly declining.

‘Looking at all the trends in this report, if an older person asked us today how confident we were that their health and care needs will be met well in the future we would be whistling in the dark if we gave a wholly reassuring answer.

‘The Government has the power to change this through its forthcoming spending review and we sincerely hope they will.'

> Read the full report: The health and care of older people 2015